Cyclodeviations, types and treatment. A case report

Part 1: Cyclodeviations: Types and treatment

In the first part of my presentation I will present a review of cyclodeviations: the causes, the symptoms that they produce and proposed treatments.

Part 2: Clinical Case

I will present the case of a 35-year-old patient who suffered a traffic accident with TBI that left her in a coma for a time. After she was discharged, she presented with diplopia caused by divergent strabismus due to the trauma and subsequent innervational problems with the 3rd cranial nerve.

She was treated with alternate occlusion and strabismus surgery, after which she presented with diplopia caused by an exocyclotropia of the left eye.

For two years she was treated with vision therapy and Fresnel prisms by a colleague using fusional ranges, central vision procedures and the wearing of minus lens hypercorrection.

Part 3: Vision Therapy

I will discuss the Vision Therapy provided to this patient since 2012, keying in on the change of approach in her treatment based on developing peripheral fusion.

I will present information about the different tools we used including yoked prisms, compensatory prisms, sectorial occlusion, therapeutic lenses and Visual Training, as well as the changes they brought about.

I will also discuss adaptations and variations of the Vision Therapy procedures that we have used.


Ana Isabel Conchillo Guerrero graduated in Optics and Optometry at the Universidad de Granada in 1998 and earned a degree in Optometry at the Universidad Alfonso X el Sabio in March 2015.

She began her training under María Jesús Izquierdo at the CEO Centre of Pamplona in 2009, where she completed the entire training programme offered there.

In the same year she opened the Vision Therapy Department at the Federópticos Trinidad Optometry Centre, which she still runs today.

Since opening the department she has attended numerous training courses among the most noteworthy of which are the 2011-2012 Advanced Specialisation in Behavioural Optometry and Vision Therapy Course given by Dr. Robert Sanet
Over the years she has continued her training by attending courses given by Harry Wachs, Susan Barry, Carl Hillier, Celia Hinrichs, Pilar Vergara, Lynn Hellerstein, Brenda Montecalvo, Lucila To and Curtis Baxstrom to name but a few.
She attended her first training course in Syntonic Optometric Phototherapy with Jesús Espinosa in 2012 before continuing with Larry Wallace, Ray Gottlieb and Stephan Collier.

She has collaborated as a lecturer at the Universidad de Sevilla, Universidad de Jaén, for the Innova Optometría optometry program, as well as for the Professional Association of Optometric Opticians of Andalusia, for which she has published a number of articles on Vision Therapy in its official magazine.

She has attended the congresses organised by SIODEC, BOAF and ICBO.

She is an auditory instructor of the Bérard method and a member of SIODEC, BOAF and of the NGO “Visió sense fronteres” (Vision Without Frontiers).

Favorite quote or phrase:

Happiness is not my destination, it is the attitude with which I journey through life.

What do behavioral optometry and vision therapy mean to you?